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*Certified Nursing Assistant Class Information This program is (Danville Area Community College)

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*Certified Nursing Assistant Class Information
This program is designed to prepare students to provide basic health care in hospitals and nursing homes.
The program will provide training experience and educational opportunities that will benefit you and
your community.
The class consists of three components: 1) 99 hours of classroom theory 3) 40 hours of clinical experience
100 % attendance is required for state certification requirements
*Successful completion of this course will allow you to test for certification by the Illinois Dept. of Public Health
ADMISSION PROCEDURE:
STEP 1: An application package must be completed with all supporting materials attached (2-Step Tuberculosis,
I want to be a CNA questionnaire, Physical Verification Form) AND it must be turned in by the deadline stated in
the application. Incomplete application packages will not be considered for enrollment. The CNA program is
extremely competitive and space is limited.
STEP 2: A limited number of applicants will be invited to attend an orientation where they will receive additional
information about completing the process to register for classes. If you are invited to an orientation but do not
attend your application will be considered void and you must complete the process again to be considered. Again,
all of the application must be filled out with required attachments or the application is void.
STEP 3: Each applicant must pass assessment at the pre-determined level.
- Eighth grade reading level
- 80% minimum score on math assessment (Remedial tutoring may be required)
(Applicant notified of results)
STEP 4: Schedule appointment with Bushue Background Screening to do a live scan fingerprint check at a
personal cost of $30.00 or $32.00 if paying by charge/debit card. (217-342-3042). The scan can be locally at the
ROE’s Office – 200 S. College, Suite B in Danville, IL.
Successful completion of all steps will place students into the first available class.
STUDENT COSTS:
- 2-Step TB test @ Verml. Co. Health Dept. $48 (cash/check or Illinois medical card)
- Course/Lab Fee $65.00 (Must be paid by 1
st
day of class)
- Uniform (white), shoes (white), watch, Cost varies (Available in DACC Bookstore)
gait (safety) belt
-Textbook / Workbook $84.50 DACC Bookstore
-Tuition & Tech fees Based on 7 credit hours
*After successful course completion: Illinois Nurse Aide Certification Exam (INACE) –
Computer-based exam $75 fee – payment made by credit or debit card
The Nurse Aide Competency Evaluation Program is a measure of nurse aide related knowledge, skills and
abilities. The purpose is to see if individuals are able to understand and safely perform the job of nurse aide. The
test is taken upon successful completion of the program.
CLASS MEETS:
DACC / Prairie Hall / Room 107-108 Instructors Office - Prairie Hall / Room 112/113
Or) DACC Higher Education Center Hoopeston 847 E. Orange Street in Hoopeston
For more information regarding registration and class schedules call 443-8782
*This program is not eligible for Federal Title IV programs (Pell/Loans) or the Illinois MAP program.
Please check
one
OFFICE STAFF ONLY:
Received by: ____________
Date:__________________
CERTIFIED NURSING ASSISTANT (CNA)
Application Packet
This program is designed to prepare students to provide basic health
care in hospitals and nursing homes. The program will provide
training experience and educational opportunities that will benefit
you and your community. To enroll in the program you must
complete this application packet in its entirety.
STEP 1: An application package must be completed with all supporting materials
attached. Incomplete application packages will not be considered for enrollment. The
CNA program is extremely competitive and space is limited.
STEP 2: A limited number of applicants will be invited to attend an orientation where
they will receive additional information about completing the process to register for
classes. If you are invited to an orientation but do not attend your application will be considered void and
you must complete the process again to be considered. Again, all of the application must be filled out with
required attachments or the application is void.
_____________________ _____________________ _____ FALL
Last Name First Name ______ SPRING
______ SUMMER
_______________________________________________________________
Street Address City State Zip code
( _____ ) ________ - _____________
Area Code Phone Number
CHECKLIST
_____ 2-Step Tuberculosis (TB) test (or verification of one within last 6 months)
_____ ‘I want to be a CNA' questionnaire
_____ Physical Verification form
2-STEP TUBERCULOSIS TEST **
Must be completed and turned in as part of the CNA application package. The TB test
cam be administered through a personal physician or the Vermilion County Health Dept.
____________________ ________________________ ______/_____/ ______
First Name Last Name Date of Birth
The First TB Test is given and read by the same health care facility of your choice within 48-72 hours.
The Second TB Test is to be completed with 7 to 21 days from the first TB test. It is given and read by
the same health care facility of your choice within 48-72 hours.
Have you ever had a positive TB test? Yes _____ No _____
TB test results will only be kept on file and counted toward meeting this requirement one year from the
date first given in TB step 1 below:
TB step 1:
Date Given: _______ Time Given ______ Lot No. ________ R. /L. Forearm Nurse: _____________
Date Read: ______________ Time Read _______________Results ________ Nurse: _____________
TB step 2:
Date Given: _______ Time Given ______ Lot No. ________ R. /L. Forearm Nurse: _____________
Date Read: ______________ Time Read _______________Results _______ Nurse: ______________
TB Update:
Date Given: _______ Time Given ______ Lot No. ________ R. /L. Forearm Nurse: _____________
Date Read: ______________ Time Read _______________Results _______ Nurse: ______________
** If you have had a TB test within the last 6 months you may submit those results
Health Care Provider Stamp here
‘I WANT TO BE A CNA' questionnaire
____________________ ________________________ ______/_____/ ______
First Name Last Name Date of Birth
1. Do you have transportation? Yes_____ No_____
2. Tell us about yourself:
3. List five qualities you possess that would make you a good candidate for the CNA
program:
4. Do you know what being a CNA entails? Briefly describe:
5. Why do you want to take this course?
‘I WANT TO BE A CNA' questionnaire page 2
6. How do you feel about working with the elderly?
7. How can we know you will be committed to the program?
8. What would you do if you heard or saw an employee physically or verbally
abusing a resident?
9. What are your career goals?
10. The class consists of three components: 15 hours of pre-employment activities; 99
hours of classroom theory; and 40 hours of clinical experience. 100% attendance
is required. What plan do you have in place to ensure you do not miss class?
11. Have you been in CNA classes before? If so, when and did you complete?
PHYSICAL VERIFICATION FORM
____________________ ________________________ ______/_____/ ______
First Name Last Name Date of Birth
Check the appropriate answer. Please answer as honestly as possible. If yes is checked, please
provide an explanation in the space provided.
YES
NO
EXPLANATION
If you are pregnant, have any back problems/lifting restrictions, or a medical condition that is
being monitored by a physician, a note will be needed from the physician that states you are in
good health, free of any communicable disease and has no known deficits that would interfere
with the ability to participate in the lab/clinical setting or in the completion of the required three
components of the CNA program, which includes 15 hours of pre-employment activities, 99 hours
of classroom theory and 40 hours of clinical experience.
Please list any other conditions that you feel may present a risk for you or that your Instructor
should be aware of to protect your well-being and safety:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Student Signature: _______________________________________________ Date: ______________
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*Certified Nursing Assistant Class Information This program is (Danville Area Community College)

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Completed 15 September 2020

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